How to Detect and Interpret OCT Artifacts

When ocular comorbidities affect the RNFL, discerning true glaucoma progression requires careful interpretation and serial imaging.

Kateki Vinod, MD

Glaucoma Physician September 1, 2025 Page(s): 6-9

Clinical Report: How to Detect and Interpret OCT Artifacts

Overview

This report highlights the significance of accurately interpreting OCT RNFL scans to avoid misdiagnosis in glaucoma management. It emphasizes the prevalence of artifacts in OCT imaging and the need for careful assessment of scan quality and data interpretation.

Background

The use of spectral-domain optical coherence tomography (SD-OCT) has become essential in diagnosing and monitoring glaucoma, particularly in patients with ocular comorbidities. However, the presence of artifacts in OCT scans can lead to misinterpretation, potentially resulting in inappropriate treatment decisions. Understanding how to identify and interpret these artifacts is crucial for effective glaucoma management.

Data Highlights

No numerical data provided in the article.

Key Findings

46% of OCT RNFL scans may contain at least one artifact.
Signal strength thresholds for adequate OCT scans differ between devices (Cirrus: >6, Spectralis: >15).
Artifacts can lead to misdiagnosis, including false positives known as 'red disease'.
Decentered scan circles can falsely suggest glaucomatous progression.
Quality indices can be affected by media opacities, leading to erroneous RNFL thickness values.
Clinicians should inspect all data points provided in OCT reports, not just average RNFL thickness.

Clinical Implications

Clinicians must prioritize the assessment of OCT scan quality and be vigilant for artifacts that may affect diagnosis and treatment decisions. Establishing a new baseline with a consistent OCT device is essential for accurate monitoring of glaucoma progression.

Conclusion

Accurate interpretation of OCT RNFL scans is vital for effective glaucoma management. Awareness of potential artifacts and their implications can significantly improve diagnostic accuracy.

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Glaucoma Physician